Individual
DR. LESLIE E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6339 N BIG HOLLOW RD, PEORIA, IL 61615-2908
(309) 693-3315
(309) 693-9385
Mailing address
6339 N BIG HOLLOW RD, PEORIA, IL 61615-2908
(309) 693-3315
(309) 693-9385
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036066136
IL
Other
Enumeration date
02/07/2006
Last updated
01/27/2010
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